This proposed project is a community based multi-risk factor intervention to improve birth outcome in a geographically defined area of Baltimore. The initiative for this study has come from the Baltimore City Health Department, and DPR has agreed to provide technical assistance, specifically regarding the design of the intervention and the evaluation of the impact of the intervention upon the target population. Outcome measures to determine the impact of this project include the rate of low birth weight and mean birth weight, as well as change in health habits, especially smoking, drinking and drug abuse, compliance with prenatal care as well as knowledge and attitudes about appropriate health behaviors during pregnancy. The timetable for the initiation of this project has been shifted since the City Health Department has not been able to secure all the funding from various non-governmental sources as well as some delays in completing the design and protocol for this project. It is now anticipated that this project will be started in September of 1990.